普通外科手术部位感染相关因素分析_医学论文.docVIP

普通外科手术部位感染相关因素分析_医学论文 普通外科手术部位感染相关因素分析_医学论文 作者：卢门永 黄秀容 叶燕婷 【摘要】目的 探讨普通外科手术患者手术部位感染(surgical site infection,SSI)的的危险因素。方法　采用前瞻性目标研究的方法,由医院感染专职人员对普通外科所有手术患者切口情况进行观察,并于手术后1个月进行电话回访,了解手术切口愈合情况。结果 普通外科住院患者800例；有27例患者发生SSI,感染率为3.33%急诊手术感染率7.33%，明显高于择期手术1.00%（x2=6.22.，0.01）；手术时间≥120 min的感染率6.66%，明显高于lt120 min 的2.61%（x2=6.33，0.01) ；围术期未使用抗生素的感染率6.42%，明显高于使用抗生素的2.72%(x2=6.55，0.01)；住院天数以大于15d的感染率9.00%，明显高于≤7d、8～14 d（x2=6.88，0.01）；Ⅲ类切口感染率7.75%，明显高于Ⅰ类、Ⅱ类切口感染率2.08%、2.08%（x2=6.98，0.01）。经多因素非条件Logistic逐步回归共筛选出6个SSI的显著变量,分别为白蛋白、血红蛋白、急诊手术、失血、切口类型、引流。结论 普通外科手术部位感染存在着多种危险因素,采取针对性的措施进行目标性监测,才能有效降低SSI的发生率。 【关键词】普通外科 伤口感染 相关因素 分析 【Abstract】 Objective To investigate the predisposing factors and prophylaxis strategy for the surgical site infection(SSI) provoked by General surgery. Methods　A prospective study was performed on surgical site in patients undergoing general surgery in our hospital and follow-up by phone after 1 month post-surgery to see how the incision healed up.Results 800 cases with gastrointestinal surgical, Among 27 patients developed SSI, infection rate was 3.33% Infection rate of 7.33% in emergency surgery were significantly higher than 1.00%in elective surgery （x2=6.22,0.01)Infection rate of 6.66% in operation time ≥ 120 min were significantly higher than that lt120 min of 2.61% (χ2 =6.33, 0.01) Infection rate 6.42% in perioperative not use of antibiotics were significantly higher than the 2.72% in use of antibiotics (χ2=6.55, 0.01) Infection rate 9.00% in hospital stay greater than the 15d were significantly higher than ≤ 7d, 8 ～14d (χ2=6.88, 0.01) Infection rate 7.75% in Ⅲ class of wound were significantly higher than 2.08%, 2.08% in wound of I andII type (χ2=6.98,0.01)Albumin and hemoglobin abnormity, emergency surgery, bleeding, incision type and eduction were risk factors of surgical site infection by multivariate Logistic regression analysis. Conclusion There are lots of SSI risk facors in general surgery, so pertinence surveillance should be taken to reduce SS